Neurocognitive effects of androgen deprivation therapy and new hormonal agents in a sample of patients with metastatic prostate cancer

• Published in: International urology and nephrology Vol. 55; no. 11; pp. 2733 - 2739
• Main Authors: Ihrig, Andreas, Pernt, Pascal Marino, Zschäbitz, Stefanie, Huber, Johannes, Friederich, Hans-Christoph, Bugaj, Till J., Maatouk, Imad
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.11.2023; Springer Nature B.V
• Subjects: Androgens; Antagonists; Cancer therapies; Chemotherapy; Clinical trials; Cognition; Cognitive ability; DRKS; DRKS00017727; Gonadotropin-releasing hormone; Luteinizing hormone; Medicine; Medicine & Public Health; Metastases; Metastasis; Nephrology; Patients; Prostate cancer; Sensorimotor integration; Urology; Urology - Original Paper; Hormonal agents; Metastatic prostate cancer; Androgen deprivation therapy; Neurocognitive effects
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-023-03712-z

Introduction Although the growing treatment landscape for metastatic prostate cancer (mPC) has revealed new opportunities, it has also provided challenges, such as undesirable side effects. The aim of the present study was to provide further data on domain-specific cognitive impairments in mPC patients with androgen deprivation therapy (ADT) and new hormonal agents. Methods Fifty-eight patients (71 ± 8 years) with mPC were investigated using a cross-sectional design. All patients had received some form of ADT (93% had received luteinizing hormone-releasing hormone (LHRH) analogs/antagonists), 66% had received chemotherapy, and 84% had received anti-resorptive therapy. We evaluated learning and memory, processing speed, and executive functions, as recommended by the International Cognition and Cancer Task Force, to determine neurocognitive deficits. Results Patients treated with ADT scored significantly lower on all neurocognitive tests and showed significantly more neurocognitive deficits (38–62%) than age-adjusted reference samples (16%, p  < 0.05). Cognitive deficits were mild in most cases and predominantly affected visuomotor processing speed (48%). Moderate and severe deficits were found in 11% and 5% of patients, respectively, with word fluency as the predominant deficit (23%). No associations were found between the type or duration of treatment and the severity of cognitive deficits. Conclusions Treatment of mPC with ADT is correlated with neurocognitive deficits in several cognitive domains. Language skills and processing speed were most frequently impaired. However, a consistent pattern of cognitive impairment was not identified. Neurocognitive deficits should be considered in phase III and IV trials. Trial registration The study was registered in the German Clinical Trials Registry (DRKS00017727).